Urology treats urinary tract diseases in all genders and male reproductive issues, covering the kidneys, bladder, prostate, urethra, from infections to complex cancers.
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For laparoscopic surgery at Liv Hospital to succeed, careful and thorough diagnosis is essential. Minimally invasive surgery needs detailed planning, since surgeons can’t see as much as they can in open surgery. Before starting, the team creates a clear map of the patient’s anatomy and checks if the patient is healthy enough for the procedure and anesthesia. This process uses advanced scans, function tests, and lab work.
Imaging gives the surgeon a clear view of what to expect before surgery. High-quality scans are crucial to decide if laparoscopic surgery is possible.
Ultrasound: While often the first line of investigation, ultrasound is less helpful for surgical planning but excellent for screening. It effectively identifies hydronephrosis (swelling of the kidney) caused by obstruction and can detect larger renal masses.
Beyond anatomy, understanding the function of the urinary tract is vital, especially when reconstructive surgery is considered.
Cystoscopy: For conditions involving the bladder or ureters, direct visualization is sometimes necessary. A flexible camera is passed through the urethra to inspect the bladder lining and the ureteral orifices. Retrograde pyelograms (injecting dye up the ureter) may be performed during this procedure to delineate the exact anatomy of the upper urinary tract.
Lab tests give important information about the body’s chemistry before surgery.
Urinalysis and Culture: Ensuring the urine is sterile before any urological instrumentation is vital to prevent sepsis. The presence of red blood cells or atypical cells in urine cytology can also confirm the diagnosis of urothelial carcinoma.
Laparoscopic surgery fills the abdomen with gas, which can affect the heart and lungs. That’s why doctors carefully check heart and lung function before the procedure.
Pulmonary Function Tests: For patients with significant lung disease, ensuring they can exchange oxygen effectively while the abdomen is distended is crucial for safety.
For complex cancer cases, a team of specialists—including urologists, radiologists, and pathologists—reviews the test results together. This teamwork helps make sure laparoscopy is the best option. The aim is to avoid surprises, so by the time surgery starts, the team knows exactly what to expect and how to proceed.
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Contrast dye highlights the blood vessels and the urinary tract on the X-ray images. The kidneys filter this dye, allowing the surgeon to see exactly where the arteries and veins are located. Since laparoscopic surgery requires precise clipping of these vessels, knowing their exact anatomy beforehand is a critical safety measure to prevent bleeding.
If you have a known allergy to iodine-based contrast or have poor kidney function, the team can use alternative imaging methods. MRI is a common substitute that uses a different type of contrast (gadolinium), which is often safe for those with iodine allergies. Alternatively, a non-contrast CT can provide anatomical information, though with less vascular detail.
During a nuclear scan, a tiny amount of radioactive tracer is injected into your vein. This tracer is taken up by the kidneys and excreted into the bladder. A special camera measures how much tracer each kidney takes up and how fast it clears it. This allows the doctor to calculate the exact percentage of function each kidney is providing.
The adrenal glands produce powerful hormones that regulate blood pressure and heart rate. If a tumor is overproducing these hormones, simply touching the gland during surgery can cause a massive spike in blood pressure. By testing hormones beforehand, doctors can prescribe specific medications to block these effects, making the surgery safe.
Generally, no. While ultrasound is excellent for finding a problem, it does not provide the 3D anatomical detail or the roadmap of the blood vessels required for safe laparoscopic surgery. A CT scan or MRI is almost always needed to give the surgeon the high-resolution information necessary for a minimally invasive approach.
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